At a time when some people may be wishing to set a New Year’s resolution, after some festive eating and drinking, it is apposite to look at a recent very striking headline:
‘I beat type 2 diabetes with 200-calorie drinks’
It describes what is said to be a very promising treatment for the treatment of type 2 diabetes. The breakthrough comes from “200 calories drinks” suggesting that if you have lots of these you can cure an illness. This seems a cheerful suggestion, and a welcome achievement of Science. The article itself, read carefully, has only two mentions of the word “fat”. Here they are:
Body fat building up around the pancreas causes stress to the beta cells in the organ that controls blood sugar levels. They stop producing enough of the hormone insulin, and that causes blood sugar levels to rise out of control. Dieting loses the fat, and then the pancreas works properly again.
This suggests to readers that it is fat round the pancreas which causes the problem, rather than being fat everywhere. In fact, although one can always quibble with epidemiological studies, being fat causes a variety of problems, including in the knees: yet another medical mystery. More widely, arthritis symptoms are worse among fat people.
What is this wonder cure based on?
Complan is what we gave decades ago to women with anorexia nervosa when they came into the York Clinic, Guy’s Hospital, at death’s door when the psychotherapists treating them had fnally realised that inpatient treatment was required. A commercial product, Complan is a vitamin drink with carbohydrates and fat and the full range of nutrients required for a balanced diet. We used a behaviour therapy routine which rewarded patients for weight gain. The total daily calorific intake was 2000-3000 calories, resulting in a mean weight gain of 12.39 kilos over 53 days, a daily gain of 234 grams, or 1.64 kilos (3.6 pounds) a week. That is in fact a reasonable estimate of the weight gains made by a totally sedentary person who eats a 3000 calorie diet. For a higher amount of calories, adjust upwards. Thermodynamics.
Here is the reference to the anorexia paper.
S.Bhanji and J.Thompson. Operant conditioning in the treatment of anorexia nervosa. British Journal of Psychiatry (1974),124,579,166 174.
Enough of that. Here is The Lancet summary of the latest paper on the “treatment” of diabetes 2:
The account does not mention fat at all. They say:
Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes.
This leads one to ask: How does one catch this illness? Is there some vaccination against this “chronic disorder”? By lifelong, does it really mean that it lasts for ever?
Later in the paper there are a few clues about weight loss after an 850 calorie per day diet. Patients had BMIs of 27 to 45 Kgs per m2 which is from “over-weight” to “morbid obesity”. Patients lost 15 Kg or more.
Patients had been put on Complan, or its equivalent, to break them from the bad habits of their habitual fattening diet. This is good news, and I am in favour of it. What irritates me is the evasion contained in this story, in that it does not mention that the “illness” of type 2 diabetes is merely a consequence of eating too much and becoming fat. What should the headline have been?
Trial shows that fat people who eat less become slimmer and healthier.
I hope this wonder treatment receives lots of publicity. If you wish to avoid hurting anyone’s feelings just don’t mention fatness. In extremis, you may talk about body fat around vital organs, but keep it brief, and generally evasive.
I see little need to update the broad conclusion: if you want to lose weight you should eat less.
However, you do not need to make a New Year’s Resolution about this. Your body is your own temple.
Happy New Year.
Disclosure: I have a wonder diet I have designed and followed since 12th March 2015. Oddly enough, it is simply a way of eating less. It is fully written up, and I am willing to disclose it at the 3 year anniversary next March, or sooner in the case of very generous donations. For all I know, it may boost your IQ.